Nexium Is Available Over the Counter — Here’s What You Should Know
Key takeaways:
Nexium (esomeprazole) is a proton pump inhibitor (PPI) medication that’s available both over the counter (OTC) and with a prescription.
OTC Nexium can help treat conditions like heartburn and gastroesophageal reflux disease (GERD). But it should only be used for a maximum of 14 consecutive days every 4 months unless a healthcare provider tells you otherwise.
OTC Nexium is available as a lower-cost generic. You can find it for less than $11 at certain pharmacies with a free GoodRx discount.
Nexium (esomeprazole) is a medication used to treat heartburn, gastroesophageal reflux disease (GERD), and other conditions caused by excessive stomach acid. It’s classified as a proton pump inhibitor (PPI) and works by lowering the amount of acid your stomach makes.
Nexium is available as a prescription and over the counter (OTC). It used to be prescription-only when it was first FDA-approved in 2001. OTC approval of Nexium 20 mg capsules happened in 2014.
The OTC product is known as Nexium 24HR. Nexium is still available by prescription in various forms and strengths, including some that aren’t available OTC. So what’s the difference between the prescription and OTC versions? Let’s discuss.
Is Nexium OTC the same as prescription Nexium?
OTC Nexium contains esomeprazole, the same active ingredient as the prescription version. But the dosages are a bit different. OTC Nexium only comes as a 20 mg capsule and tablet. Prescription Nexium is available as 20 mg and 40 mg capsules and a powder that can be made into an oral liquid by a pharmacist.
Before the prescription status of a medication can be changed to OTC, the FDA evaluates the OTC version for both safety and effectiveness. So the OTC version is just as safe and effective as the prescription version.
OTC medications are intended to treat minor health conditions or mild symptoms. They have clear directions that the average person can easily follow. But it’s important to follow those directions and ask your pharmacist or healthcare provider if you have any questions or concerns.
The OTC Nexium package instructions recommend only taking the medication for 14 days within a 4-month period. If you need the medication longer than 14 days, it could mean that you have a condition that needs to be diagnosed and treated by a healthcare provider.
Sometimes your healthcare provider may recommend taking OTC Nexium for longer than 14 days. In that case, it’s OK to take it for a longer time. They also may give you a prescription for Nexium in this case.
What are the benefits of Nexium OTC?
The benefits of OTC Nexium are similar to prescription Nexium, as well as other PPIs like omeprazole (Prilosec). OTC Nexium is FDA-approved to help with symptoms of heartburn and acid reflux. The biggest benefit is the convenience of being able to buy OTC Nexium without needing to see a healthcare provider.
For more severe conditions, like GERD, erosive esophagitis, and stomach ulcers, Nexium can be an effective treatment. But these conditions shouldn’t be treated at home without a healthcare provider’s instructions. They typically require monitoring and check-ups to make sure they’re improving.
Are the side effects the same as prescription Nexium?
Yes, the side effects of OTC Nexium are the same as prescription Nexium. They both contain the same active ingredient: esomeprazole. These side effects tend to be mild and are similar to other PPIs.
Common side effects of Nexium include:
Headache
Nausea
Diarrhea
Gas
Constipation
Stomach pain
Many of these side effects can be managed at home. If you have side effects that don’t seem to go away or are too bothersome, contact your healthcare provider. They can recommend how to handle the side effects.
How do you take Nexium OTC?
For adults, the dosage for OTC Nexium is 1 tablet or capsule by mouth once a day for a maximum of 14 days. Swallow the pill with a full glass of water before your first meal of the day. Don’t crush or chew the medication.
It can take 1 to 4 days to feel the full effects of OTC Nexium. So try to be patient and give the medication a chance to work.
Can you take Nexium OTC every day?
No, unless your healthcare provider tells you this is OK. If you’re self-treating, you should only take OTC Nexium for a maximum of 14 days every 4 months. You should speak with your healthcare provider if you feel like you need to take it longer than this.
PPIs like Nexium also have a risk of long-term side effects. These include lower bone density (weaker bones) and a higher chance of infections like pneumonia. So it’s usually best to use these medications for the shortest amount of time needed. But for some conditions, you may need to take a PPI like Nexium every day long term to prevent or help repair damage to your esophagus.
Your healthcare provider can help you determine whether you should take Nexium every day, and how long to take it for.
How to save on Nexium
There are many ways to save on Nexium, which is available as both a brand-name and generic medication. By asking your healthcare provider to write a prescription for OTC Nexium, you can apply a GoodRx coupon to help you save.
Save with GoodRx. GoodRx can help you save over 50% off the average retail price of the generic version. Generic Nexium 24HR’s price at certain pharmacies is less than $11 with a free GoodRx discount.
Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $15 for prescription Nexium using a savings card from the manufacturer.
The bottom line
Nexium is a PPI medication that’s available both OTC and by prescription. The OTC and prescription products contain the same active ingredient, esomeprazole. So they work the same way and have the same side effects. The prescription version is available as a higher dose (40 mg), whereas Nexium OTC is only available as a 20 mg dose.
Usually, OTC Nexium should only be used for 14 days at a time. But your healthcare provider may recommend taking it for longer than that. Check with your healthcare provider before starting OTC Nexium to be sure it’s safe for you to take.
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References
DailyMed. (2022). Esomeprazole magnesium.
DailyMed. (2022). Nexium 24HR drug label information.
Fattahi, M. R., et al. (2019). The association between prolonged proton pump inhibitors use and bone mineral density. Risk Management and Healthcare Policy.
Katz, P. O., et al. (2022). ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. The American Journal of Gastroenterology.
Nguyen, P. A., et al. (2020). Meta-analysis of proton pump inhibitors induced risk of community-acquired pneumonia. International Journal for Quality in Health Care.
Pfizer. (2014). Pfizer statement on U.S. FDA approval of over-the-counter Nexium® 24HR.
RemedyRepack Inc. (2022). Nexium [package insert].
U. S. Food and Drug Administration. (2001). Drug approval package: Nexium.
Yibirin, M., et al. (2021). Adverse effects associated with proton pump inhibitor use. Cureus.
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